INFLUENCE OF BREAST-MILK, SOY OR 2 HYDROLYZED FORMULAS ON THE DEVELOPMENT OF ALLERGIC MANIFESTATIONS IN INFANTS AT RISK

Background: Infants born to atopic parents are at an increased risk of developing allergy during the first 2 years of life. Objective: To as sess the effects of the early introduction of soy, extensively-hydroly zed casein, or partially-hydrolyzed whey formulas in infants at risk f or atopic diseases. Methods: This prospective, double-blind study comp ared allergic manifestations in 113 formula-fed and 17 breast-fed infa nts during the first year of life. The children were equally distribut ed among feeding groups by sex, birth IgE levels, and parental atopy. Study formulas were introduced in the newborn nursery. Gastrointestina l and dermatologic manifestations suggestive of allergy were evaluated at regular intervals during the first year of life. Results: The cumu lative incidence of chronic or recurrent vomiting, diarrhea or atopic dermatitis in the first year of life was 18%. Persistent symptoms led to a formula change in 18 (16%) of the formula-fed infants (mean age o f change: 2.3 months). Formula intolerance was confirmed by an open ch allenge with the first formula in 15 infants (13%), without significan t differences in the number of children with formula changes and posit ive challenges across all feeding groups. Conclusions: There was no si gnificant difference among the formula groups in the development of sy mptoms of food intolerance. However, introduction of hydrolyzed cow's milk or soy infant formulas at birth to infants at risk for developing allergy did not completely prevent the development of symptoms common ly attributed to food intolerance. Of the infants who developed intole rance to one of the study formulas 81% improved when changed to a seco nd, randomly-assigned formula, suggesting that intolerance was formula specific. (C) 1998 Elsevier Science Inc.